The association of the decline in glomerular filtration rate with aggressive endometrial cancers

Int Urol Nephrol. 2020 Jan;52(1):161-168. doi: 10.1007/s11255-019-02324-w. Epub 2019 Nov 1.

Abstract

Purpose: Most site-specific cancer incidence is increased with the decrease of glomerular filtration rate (GFR). We analyzed endometrial cancers depending on different type, staging, and histology grades. We hypothesized that patients with lower GFR levels have an increased risk for higher staging and histology grades of endometrial cancers.

Methods: Patients were divided into two subgroups regarding GFR; the first group with GFR < 60 ml/min and the second group with GFR > 60 ml/min and regarding different histology grades and cancer stages. Cancers were also divided by stages (1-4). Patients were followed up during 1 year through regular controls in the outpatient clinic and during that time cancer recurrence was recorded.

Results: GFR was the strongest predictor for higher cancer histology grade and higher cancer staging. Patients with reduced GFR had OR for higher histology grade and higher staging of 1.06 and 1.06. Traditional risk factors for endometrial cancer development were not associated with higher histology grade or higher cancer staging.

Conclusion: Higher staging and histology grades in patients with endometrial cancers are associated with reduced GFR. Patients with mild-to-moderate CKD had significantly higher number of cancers with higher histology grades and higher stages than patients with mild or normal GFR category. Decline in GFR was independently associated with more aggressive cancers without other well-known risk factors for endometrial cancer development like age, menopause, diabetes, and obesity.

Keywords: Endometrial cancer; Glomerular filtration rate; Histology; Risk factors; Stage.

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / physiopathology*
  • Aged
  • Endometrial Neoplasms / complications
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / physiopathology*
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Factors